Lessons Learned from the Implementation of a Person-Centred Digital Health Platform in Cancer Care.

The SARS-CoV-2 (COVID-19) pandemic has accelerated the development and use of digital health platforms to support individuals with health-related challenges. This is even more frequent in the field of cancer care as the global burden of the disease continues to increase every year. However, optimal implementation of these platforms into the clinical setting requires careful planning and collaboration. An implementation project was launched between the Centre intégré universitaire de santé et de services sociaux (CIUSSS) du Centre-Ouest-de-I'Île-de-Montreal and BELONG-Beating Cancer Together-a person-centred cancer navigation and support digital health platform. The goal of the project was to implement content and features specific to the CIUSSS, to be made available exclusively for individuals with cancer (and their caregivers) treated at the institution. Guided by Structural Model of Interprofessional Collaboration, we report on implementation processes involving diverse stakeholders including clinicians, hospital administrators, researchers and local community/patient representatives. Lessons learned include earlier identification of shared goals and clear expectations, more consistent reliance on virtual means to communicate among all involved, and patient/caregiver involvement in each step to ensure informed and shared decision making.

The Meaning and Experience of Patients Undergoing Rectal High-Dose-Rate Brachytherapy.

BACKGROUND: High-dose-rate (HDR) brachytherapy is a precise form of radiation therapy that targets cancerous tumors by directly applying the radiation source at the site or directly next to the tumor. Patients often experience but underreport pain and anxiety related to cancer treatments. At present, there is no research available concerning the pervasiveness and intensity of patients' pain and anxiety during rectal brachytherapy. OBJECTIVE: The aim of this study was to examine patients' thoughts, emotions, coping strategies, physical sensations, and needs during rectal HDR brachytherapy treatment. METHODS: Twenty-five patients with rectal cancer were interviewed using a semi-structured qualitative interview following the completion of their brachytherapy treatment delivered at a Montreal-based hospital in Quebec, Canada. RESULTS: The experiences of pain and discomfort varied greatly between patients and were linked to the meaning patients attributed to the treatment itself, sense of time, the body's lithotomic position, insertion of the treatment applicator, and the patients' sense of agency and empowerment during the procedure. Patients drew upon a variety of internal and external resources to help them cope with discomfort. CONCLUSION: Staff need to know about the variation in the physical and emotional experiences of patients undergoing this treatment. IMPLICATIONS FOR PRACTICE: Clinical teams can tailor their procedural behavior (eg, using certain language, psychosocial interventions) according to patients' needs to increase patients' comfort and ultimately improve their experience of HDR rectal brachytherapy.